RESUMEN
Orina oscura no siempre significa hematuria. Diversas situaciones clínicas y pigmentos orgánicos e inorgánicos pueden modificar el color amarillento pajizo de la orina normal. Conviene diferenciar a simple vista las diversas tonalidades cromáticas de la orina para no confundir las distintas situaciones clínicas que la provocan. La tirilla reactiva es la prueba inicial más eficaz para discriminar la hematuria de la hemoglobinuria/mioglobinuria, la bilirrubinuria y la coluria. En este trabajo se repasan las principales causas de orina oscura, coluria y pigmenturia (AU)
Dark urine does not always mean hematuria. Various clinical and organic and inorganic pigments can dye urine modifying the straw yellow color of normal urine. Should distinguish at a glance the various chromatic tones of urine in order not to confuse the different clinical situations that cause it. The dipstick test is the most effective initial test to discriminate hematuria and hemoglobinuria/myoglobinuria. This paper reviews the main causes of dark urine, choluria and pigmenturia (AU)
Asunto(s)
Humanos , Urinálisis/métodos , Pigmentos Biológicos/orina , Diagnóstico Diferencial , Hematuria/diagnóstico , Tiras ReactivasRESUMEN
BACKGROUND: Laparoscopic splenectomy (LS) offers better short-term results than open surgery for the treatment of immune thrombocytopenic purpura (ITP), but long-term follow-up is required to ensure its efficacy. The remission rate after splenectomy ranges from 49 to 86% and the factors that predict a successful response to surgical management have not been clearly defined. The goal of this study was to determine the preoperative factors that predict a successful outcome following LS. METHODS: From February 1993 to December 2003, LS was consecutively performed in a series of 119 nonselected patients diagnosed with ITP (34 men and 85 women; mean age, 41 years), and clinical results were prospectively recorded. Postoperative follow-up was based on clinical records, follow-up data provided by the referring hematologist, and a phone interview with the patient and/or relative. Univariate and multivariate analyses were performed for clinical preoperative variables to identify predictive factors of success following LS. RESULTS: Over a mean period of 33 months, 103 patients (84%) were available for follow-up with a remission rate of 89% (92 patients, 77 with complete remission with platelet count > 150,000). Eleven patients did not respond to surgery (platelet count < 50,000). Mortality during follow-up was 2.5% (two cases not related to hematological pathology and one case without response to splenectomy). Preoperative clinical variables evaluated to identify predictive factors of response to surgery were sex, age, treatment (corticoids alone or associated with Ig or chemotherapy), other immune pathology, duration of disease, and preoperative platelet count. In a subgroup of 52 patients, we also evaluated the type of autoantibodies and corticoid doses required to maintain a platelet count > 50,000. Multivariate analysis showed that none of the variables evaluated could be considered as predictive factors of response to LS due to the high standard error. CONCLUSION: Long-term clinical results show that LS is a safe and effective therapy for ITP. However, a higher number of nonresponders is needed to determine which variables predict response to LS for ITP.
Asunto(s)
Enfermedades del Sistema Inmune/cirugía , Laparoscopía , Púrpura Trombocitopénica/cirugía , Esplenectomía , Adolescente , Adulto , Anciano , Femenino , Humanos , Enfermedades del Sistema Inmune/sangre , Enfermedades del Sistema Inmune/mortalidad , Masculino , Persona de Mediana Edad , Análisis Multivariante , Recuento de Plaquetas , Pronóstico , Estudios Prospectivos , Púrpura Trombocitopénica/sangre , Púrpura Trombocitopénica/mortalidad , Inducción de Remisión , Resultado del TratamientoAsunto(s)
Enterococcus faecalis , Infecciones por Escherichia coli/diagnóstico , Infecciones por Bacterias Grampositivas/diagnóstico , Infecciones por Pseudomonas/diagnóstico , Enfermedades de la Vejiga Urinaria/diagnóstico , Infecciones Urinarias/diagnóstico , Adulto , Diagnóstico Diferencial , Humanos , Masculino , Cálculos de la Vejiga Urinaria/diagnósticoRESUMEN
La prostatitis es un síndrome que se presenta con inflamación y/o infección de la próstata, disuria, síntomas obstructivos, dolor perineal, polaquiuria y eyaculodinia. Existen formas bacterianas y abacterianas. ES difícil diagnosticarla si no se trata de la forma bacteriana aguda., y resulta complicado diferenciar entre la prostatitis crónica bacteriana, la abacteriana y la prostatodinia, ya que sus síntomas pueden ser similares. Con esta revisión, pretendemos aclarar cuál es la clínica de cada una de estas formas, así como su diagnóstico y tratamiento
Prostatitis is a syndrome that presents with symptoms consistent with inflammation and/or infection of the prostate gland, including terminal dysuria, dysfunctional voiding, perineal pain, increased frequency of urination and pain ejaculation. There is bacterial and nonbacterial prostatitis. It is difficult to diagnose prostatitis unless it is the acute bacterial variety and it is difficult to differentiate among chronic bacterial prostatitis, nonbacterial prostatitis and prostatodynia, because symptoms and physical findings may be similar
Asunto(s)
Masculino , Humanos , Prostatitis/diagnóstico , Prostatitis/complicaciones , Inflamación/diagnóstico , Inflamación/epidemiología , Prostatitis/etiología , Próstata/patología , Enfermedades de la Próstata/epidemiología , Prostatitis/epidemiologíaRESUMEN
El carcinoma de uraco es una patología vesical excepcional Su expresión morfológica más frecuente es el adenocarcinoma mucosecretor. Su localización exclusiva es la cúpula vesical y la línea media de cara anterior y posterior, pudiéndose extender hacia el espacio de Retzius. La clasificación de la extensión es la de Sheldon, ya que no existe una clasificación de la UlCC
Urachal carcinoma is an exceptional bladder patbology. lts most frequent morpbologic expression is mucous-secreting adenocarcinoma. It is located exclusively in the bladder dome and in tbe midline oftbe tbe anterior and posterior faces oftbe bladder; it may also extend forward to tbe Retzius space. As tbere is no UICC classification, tbe classification of tbe extension is Sheldon's